1/9. Early pregnancy uninterrupted by laparoscopic bipolar coagulation of uterine vessels.Laparoscopic bipolar coagulation of uterine vessels (LBCUV) is reported to treat clinically symptomatic myomas that caused severe menorrhagia, but the viability of pregnancy after operation is unknown. A woman with clinically diagnosed uterine myomas, possibly with adenomyosis, had unexpected early pregnancy diagnosed at the time of LBCUV. The procedure resulted in improvement of menorrhagia to normal menstruation and reductions in the volume of both uterus and myomas. The intrauterine pregnancy was terminated at the woman's request. pregnancy may be possible after LBCUV, although none has been reported.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Multiple uterine angioleiomyomas in a woman presenting with severe menorrhagia.BACKGROUND: Angioleiomyoma is a rare benign neoplasm that originates from smooth muscle cells and contains thick-walled vessels. There were only five cases of uterine angioleiomyoma reported in the available English literatures. We present here the unique computed tomography finding in a patient with multiple uterine angioleiomyomas causing severe menorrhagia. CASE: A 50-year-old, nulligravid woman consulted us with the complaint of menorrhagia for 3 years and progressively palpable lower abdominal mass for a half year. Laboratory findings were all within normal limits except lower hemoglobin concentration (6.2 g/dl). An abdomino-pelvic computed tomography (CT) showed that a huge 30-cm heterogeneously multilobulate mass with solid and laminated configuration, with cystic and multiseptal contents was found in left lower abdomen and pelvic cavity. At laparotomy, the area beneath the left broad ligament was filled with a well-encapsulated, elastic, ovoid, and lobulate mass that connected to the uterus and measured up to 20 cm in greatest diameter. The uterus was composed of a huge intramural tumor and measured 28 x 21 x 12 cm. The uterus and huge subserosal tumor were resected completely and a frozen section was obtained. The final histopathologic diagnosis was angioleiomyoma, a definitely benign soft tissue tumor. Eighteen months after surgery there was no recurrence. CONCLUSION: Uterine angioleiomyoma should be considered when prominent tortuous vascular-like enhancing structures are noted on CT examination of a well-demarcated soft tissue mass arising from the uterus in pelvis. Either angiomyomectomy with tumor-free margins or hysterectomy proved to be an effective treatment in these cases, and resulted in a good recovery and a satisfactory outcome.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
3/9. Conservative treatment by angiographic artery embolization of an 11-week cervical pregnancy after a period of heavy bleeding.OBJECTIVE: To describe a rare case of conservative treatment of an 11-week cervical pregnancy after a period of heavy bleeding. DESIGN: Case report. SETTING: A university hospital. PATIENT(S): A 33-year-old woman was admitted to our hospital for treatment of a cervical pregnancy. Two-and-a-half years thereafter, she gave birth to a healthy baby by vaginal delivery at 38 weeks of gestation. INTERVENTION(S): Systemic methotrexate treatment, ligation of descending branches of uterine arteries, cervical cerclage, and unilateral internal iliac artery embolization. MAIN OUTCOME MEASURE(S): Transvaginal ultrasound, magnetic resonance imaging, and arteriography findings. RESULT(S): The patient was successfully treated with unilateral internal iliac artery embolization on the same side as the pregnancy in the 11th gestational week. CONCLUSION(S): After failed methotrexate and vessel ligation in cervical pregnancy, unilateral internal iliac artery embolization is an effective and conservative treatment that allows preservation of reproduction potential.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
4/9. Embolization of a massive retropubic hemorrhage following a tension-free vaginal tape (TVT) procedure: case report and literature review.INTRODUCTION: Since its description by Ulmsten, the TVT procedure has been proven to be safe and well tolerated. Bleeding and hematoma formation, although rare, can occur. Both conservative and surgical managements of this complication have been described. MATERIALS: We report the first case in which a pelvic branch of the obturator artery was embolized using angiography. RESULTS: Our patient was spared surgical exploration and retained the TVT tape. CONCLUSION: angiography with vessel embolization, when available, should be considered in the treatment of TVT-procedure retropubic hemorrhages.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
5/9. arteriovenous malformations of the uterus.Six cases of the rare condition of arteriovenous malformation of the uterus are reported. Uterine bleeding was the most common presentation, with the site of the lesion and the caliber of the vessels determining its degree. A preoperative diagnosis was made by angiography in two patients, and was aided by ultrasonography in one.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
6/9. life-threatening hemorrhage due to uterine vascular abnormality.A case is reported of a 25-year-old woman stricken with prolonged and life-threatening menorrhagia from abnormal uterine vessels resembling hemangioma cavernosum. The condition was suspected at ultrasonic investigation. hysterectomy was performed as an emergency operation.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
7/9. Carotid artery thrombus associated with severe iron-deficiency anemia and thrombocytosis.BACKGROUND: Thrombus within the carotid artery usually occurs in vessels with severe atherosclerotic disease and may embolize to cause transient ischemic attacks and cerebral infarctions. The risk factors for carotid artery thrombus formation in the absence of atherosclerosis are not well characterized. A case series is presented that suggests an association of carotid artery thrombus with severe iron-deficiency anemia and thrombocytosis. CASE DESCRIPTIONS: We describe three women with severe iron-deficiency anemia and thrombocytosis secondary to menorrhagia who developed carotid artery thrombi. Thrombi were detected radiographically. The patients were treated with anticoagulation and antiplatelet therapy. In two patients, follow-up neuroimaging 10 to 14 days later demonstrated resolution of the thrombus and no identifiable vascular disease. CONCLUSIONS: Severe iron-deficiency anemia with thrombocytosis may be a risk factor for carotid artery thrombus formation. Medical management with anticoagulation and antiplatelet therapy is a reasonable approach for these patients while the thrombus resolves.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
8/9. Endometrial ablation for severe menorrhagia in a patient with hereditary hemorrhagic Telangiectasia. A case report.BACKGROUND: Hereditary hemorrhagic telangiectasia is a rare, inherited disease characterized by abnormal visceral and superficial blood vessel anastomoses. These telangiectasias predispose the patient to a lifelong history of recurrent bleeding for the nasal and gastrointestinal mucosa. Less commonly involved organs include the liver, brain and lung. To date there is no cure for this disease. Management requires many palliative minor surgical procedures to stop actively bleeding sites. Major surgery is often contraindicated in these patients due do coexisting medical sequelae of their underlying disease. CASE: menorrhagia was diagnosed in a 42 year-old multipara with known history of hereditary hemorrhagic telangiectasia. The bleeding was unresponsive to hormonal therapy. Substantial preexisting conditions, including profound anemia, history of multiple strokes, a seizure disorder and ventricular arrhythmias, precluded major surgical intervention, including hysterectomy. Serial injections of leuprolide acetate injections were followed by hysteroscopic "rollerball" electrocoagulation of the endometrium under regional anesthesia. On long-term follow up, the patient was cured of her menorrhagia. CONCLUSION: Endometrial ablation provides patients who have significant medical complications with an effective, minimally invasive alternative to hysterectomy for control of menorrhagia.- - - - - - - - - - ranking = 0.2keywords = vessel (Clic here for more details about this article) |
9/9. Transarterial embolization of the uterine arteries: patient reactions and effects on uterine vasculature.BACKGROUND: Therapeutic embolization of the uterine arteries has been successfully used to manage profuse gynecological hemorrhage. In the present study we aimed to investigate whether embolization of uterine arteries may serve as a safe and effective alternative treatment in cases of menorrhagia in fertile and perimenopausal women. As a first step, we have evaluated the methodology, patient reactions and effects on the uterine vasculature. methods: The distal part of the uterine artery was embolized with polyvinyl alcohol particles via catheterization of the right femoral artery. Total abdominal hysterectomy was performed the next day. RESULTS: Bilateral embolization in two patients resulted in considerable pain that required morphine analgesic medication and epidural analgesia. One patient was embolized unilaterally and experienced only slight discomfort with no need for analgesic medication at all, indicating that unilateral embolization is a well-tolerated method. After embolization, angiography showed stagnant flow in embolized vessels without contrast filling of distal branches. angiography of the specimen showed normal vascular architecture in non-treated vessels. In treated vessels the main arterial trunks were patent but all smaller branches were occluded. histology showed that most of the particles lodged in small arteries and that arterioles never showed injected material. CONCLUSION: The study indicates that the procedure involves an efficient occlusion of uterine vessels and that unilateral embolization of uterine arteries is well tolerated.- - - - - - - - - - ranking = 0.8keywords = vessel (Clic here for more details about this article) |